Madison Dental Group

Cosmetic Dentistry

Madison, NJ

973-377-7088

PATIENT INFORMATION

Insurance Information

Your dental plan is part of your benefit plan provided by your employer. You can expect your dental insurance carrier to reimburse you for a portion of your dental expense. That portion is determined by the contract between your employer and the insurance company. 

We want to help you receive the maximum reimbursement to which you are entitled. We will provide dental x-rays and a written diagnostic report should your insurance company have any questions about the services provided.

Full payment is due at the time of service, and we will submit claims indicating that the insurance check be sent directly to you.

At all times, we will provide you with our best services without regard to the limitations imposed by your insurance coverage.  We have built our reputation on excellence and will not compromise treatment because of insurance limitations.  Dr. Romano and Dr. Adams do not participate with many insurance plans because of who dictates the quality of care to be provided.

Facts About Dental Insurance

As an optimal care dental practice, our patients deserve the best possible dental services we can provide. Here are some interesting facts about dental insurance.

Fact#1:

 Your dental insurance is based upon a contract between your employer and the insurance company. Should questions arise regarding your dental insurance benefit, it is best for you to contact your employer or insurance company directly.

Fact#2:

 Dental insurance benefits differ greatly from general health insurance benefits. In 1971, your dental insurance benefits were approximately $1,000 per year. Figuring a 6% rate of inflation per year, you should be receiving $4,549 per year in dental benefits. Your premiums have increased, but your benefits have not. Therefore, dental insurance is never a pay-all, it is only aid.

Fact#3:

 You may receive a notification from your insurance company stating that dental fees are "higher than usual and customary." An insurance company surveys a geographic area, calculates an average fee, takes 80% of that fee and considers it customary. Included in this survey are discount dental clinics and managed care facilities, which bring down the average. The fee-for-service doctor in private practice will have fees that insurance companies define as higher that "usual and customary."

Fact#4:

 Many plans tell their participants that they will be covered "up to 80% or up to 100%," but do not clearly specify plan fee schedule allowances, annual maximums or limitations. It is more realistic to expect dental insurance to cover 35% to 65% of major services. Remember, the amount a plan pays is determined by how much the employer paid for the plan. You get back only what your employer put in, less the profits of the insurance company.

Fact#5:

 Many routine dental services are not covered by insurance companies.

Financial arrangements must be made directly with us, regardless of insurance coverage. You will need to file a claim form with your insurance company to receive your benefits.

Please do not hesitate to ask us any questions about our office policies. However, if you have questions regarding your insurance benefits, please contact your employer or insurance carrier directly.